Arrhythmogenic mechanisms for the sudden death in heart failure

Heart failure (HF) is a major clinical manifestation of many cardiac disease processes when the cardiovascular compensatory mechanisms fail. Five million patients suffer from HF with an additional 555,000 new patients diagnosed HF annually. Moreover, there are an estimated 400,000 to 460,000 deaths attributable to sudden cardiac death (SCD) in the United States each year.1 Mortality in the heart failure population is about six to seven times higher than that of the agematched general population. Approximate 40%-50% of the total mortality in HF patients is associated with SCD, of which ventricular tachyarrhythmias are the underlying cause for the majority of cases.2-4 However, the mechanisms of SCD in HF is not yet fully understood. In the following review, we will focus on arrhythmogenic substra